zoonosis gnccb ps leg aok m 2009
TRANSCRIPT
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ZoonosisokLegionellosis
Pseudomonas csoports Acinetobacter
ZoonosisokLegionellosis
Pseudomonas csoports Acinetobacter
Dr.Dr. BerekBerek ZsuzsannaZsuzsanna2008 Okt2008 Oktber 29ber 29
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GRAM NEGATIV PLCK
AEROB
BordetellaBrucella(Z)Francisella(Z)
PseudomonasAcinetobacterLegionella
FAKULTATIV ANAEROB
HaemophilusPasteurella (Z)
Familia:EnterobacteriaceaeVibrionaceae
CardiobacteriumEikenellaKingella
Actinobacillus
ANAEROB
BacteroidesPrevotellaPorphyromonas
Fusobacterium
MIKROAEROPHILCampylobacter
Helicobacter
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Zoonosisokoonosisok: BrucellaBrucella
Francisella Pasteurella s a
rancisella Pasteurella s a
Pestis
estis
1. Brucella1. Brucella
Sir David Bruce (1855-1931)www.lshtm.ac.uk/.../archives/images/bruce1.jpg
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rucellae
Morphologia:Gram negativ Coccobacillus
Tenyszts:Agar - dsts(Serum, Glycerine)CO2
21 nap
Rezisztens!
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Description: Brucella spp. Colony Characteristics: - A. Fastidious, usually not
visible at 24h. - B. Grows slowly on most standard laboratory media (e.g. sheepblood, chocolate and trypticase soy agars). Pinpoint, smooth, entire translucent,non-hemolytic at 48h
staff.v
bi.vt.e
du/pathport/p
athinfo_
images/Bru...
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rucellae
Pathogenesis, Infectio, Krkpek
B. melitensis kecske mltai lzB. abortus szarvasmarha Morbus BangB. suis serts serts Brucellosis
Anthropozoonosis MIND BrucellosisFebris undulans RES!(hullmz = undull lz)
-forrs beteg llatok (hs, tej)-tvitel direkt Kontaktus vagy kontaminldott lelmiszer
-behatols b
rsrls vagy conjunctiva vagy blnylkahrtya
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Brucella fertzs forrsa
Medmicro
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Brucella behatolsi kapuk
Figure
28-1Portalsof
entryforBruc
ellaspecies.
Medmicro
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Brucella sztterjeds
Medmicro
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Figure.Acute unilateral scrotal swellingin a 27-year-old man with brucellosis.
www.medscape.com/.../art-iim441224.fig.jpg
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Fig.13.36 Brucellosis. Arthritis of theleft knee. This was accompanied by
fever, malaise, generalized myalgia anddepression.Fig. 13.37 Orchitis B. abortus
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Brucellosis - diagnosis
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Diagnosistenyszts: min. 5 napSzerologia
Ellenanyag kimutatsCs-agglutinatio (Wright)IgM Chromatographia
ELISA
Therapia:
Doxycyclin, Rifampicin, StreptomycinProphylaxis:Biztonsgi/munkavdelmi rendszablyok
Beteg llatok gygytsa, megsemmistseWHO Bioterrorkategoria B!!!
Brucella IgM
www.kit.nl
ru ellosis
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2. Francisella2. Francisella
Zoonosisok
oonosisok
: Brucella
Brucella
Francisella Pasteurella s a
rancisella Pasteurella s a
Pestisestis
Tulare Lake; California, USA
http://upload.wikimedia.org/wikipedia/commons/3/34/Pine_Flat_Lake_1.jpghttp://upload.wikimedia.org/wikipedia/commons/3/34/Pine_Flat_Lake_1.jpg -
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Francisella tularensis
Morphologia:Gram negativ plck
Hidegtr!
Tenyszteni tilos!Csak specilis laboratriumokban
WHO Bioterrorkategoria A!!!
Pathogenesis, Infectio- forrs: Beteg llatok- tvitel: direkt kontaktusvagy belgzs vagy per os vagy via Ektoparasitk
EMBERRL EMBERRE NEM TERJED!
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Francisella tularensis
Krkpek:TULARAEMIAnyirokcsomkban, apr granulomk
+ feklyek+ necrosisPrimer Komplex
cutano-, oculo-, tonsilloglandularis, (ltszik!)thoracalis, abdominalis - (nem ltszik!) formkGeneralisatio Granuloma kpzds!
Diagnosis: SzerologiaProphylaxis:Expositios - prophylaxis
Therapia:Streptomycin, Doxycyclin,Ciprofloxacin
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A reported case ofexposure of a patient toa wild rabbit, whichsubsequently died,
suggested that tularemiawas the likely etiology
staff.vbi.vt.edu/.../Ftularensis
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Description: Cervical Lymphadenitisin a Patient WithPharyngeal Tularemia;
Patient has marked swelling and fluctuant suppuration of several anteriorcervical nodes. Infection was acquired by ingestion of contaminated food orwater. Source: World Health Organization
staff.vbi.vt.e
du/.../Ftular
ensis
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Description: Chest
Radiograph of a Patient WithPulmonary Tularemia
Description: TheseFrancisellatularensis colonies show characteristicopalescence on cysteine heart agar
with sheep blood (cultured at 37 C for72 hours). Note: On cysteine heartagar, F tularensis colonies arecharacteristically opalescent and do
not discolor the medium
staff.vbi.vt.edu/.../Ftularensis
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Zoonosen
oonosen
: Brucella
Brucella
Francisella Pasteurella und
rancisella Pasteurella und
Pestest
3. Pasteurella3. Pasteurella
Louis Pasteur (1822-1895)
upload.wikimedia.org/.../4/42/Louis_Pasteur.jpg
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medecinepharmacie.univ-fcomte.frPasteurella multocida
Morphologia:Gram negatv, kicsi plck
Pathogenesis:
Macska vagy kutya haraps
immunkrosodott: Sepsis!
Therapia: sebszi, Penicillinek
Tenyszts:Vres- s csokold agar
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aapredbook.aappublications.org
Pasteurella multocida
Fig. 10.55 Animal bite.Infected wound of fingerfollowing bite of domestic
cat. P. multocida wasisolated from the wound.
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aapredbook.aappublications.org
Pasteurella
multocidacellulitissecondary tomultiple cat
bites about theface of a one-year-old child
?
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?
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4. Feketehall4. Feketehall Yersinia pestisYersinia pestis
Zoonosisok
oonosisok
: Brucella
Brucella
Francisella Pasteurella s a
rancisella Pasteurella s a
Pestisestis
1863 - 1943
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Yersinia pestis
genus: Enterobacteriaceae!
Morphologia: Gramnegativ plck bipolaris festds
www.lonlygunmen.deGiemsa fests www.mja.com.au
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www.idph.state.il.us, www2.cnrs.fr, ww.knowledgenews.net,
Yersinia pestis
TENYSZTS: TILOS!Csak specilis laboratriumokbanWHO Bioterror kategria A!!!
Pestis - XIV. sz.
http://www.idph.state.il.us/http://www.knowledgenews.net/http://www.knowledgenews.net/http://www.idph.state.il.us/ -
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Pestis XIV. sz.
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Yersinia pestis
VIRULENCIA FAKTOROK
TOK Protein!V Antigen (Protein) AntiphagocyterW Antigen = Endotoxin
Extracellularis
- Plasminogen Aktivator Protein (Pla)sztterjeds, fibrinolysis
-Toxin (egr)
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Yersinia pestis
Pathogenesis, Infectio:forrs:
Patkny (s ms rgcslk) Patknyirts!!!
tvitel:
direkt kontaktus,Patknybolha cspse
behatols: br
Yersinia pestis
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Figure 29-4 Pathogenesis ofY. pestis in plague patients.
Medmicro
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Krkpek:1)Bub pestis
(nyirokcsommegnagyobbods)
2) Szeptikus forma haemorrhagis gyullads
3) Tdpestis = Pneumonia (haemorrhagis) direkt aerogen tvitel, emberrl emberre(cseppfertzs primer tdpestis)!
Yersinia pestis
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Fig. 13.55 Plague. Enlarged tender inguinal lymphnodes in a Vietnamesechild with bubonic plague.Fig. 13.56 Advanced stage of inguinal lymphadenitis in bubonoc plague.The nodes have undergone suppuration and the lesion has drained
spontaneously.By courtesy of Dr. J.R. Cantey
Bubopestis
N i f
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Necrosis offinger tips of
septicemicplague.
www.imcworldwide.org
Cutaneous Hemorrhages in Plague. Source www.cdc.gov
Sepsis
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www.imcworldwide.orgTdpestis
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Yersinia pestis
DiagnosisKlinikaiDirekt kimutats - Mikroszkpos
Szerologia cs-agglutinatio, IF
Therapia:
Doxycyclin, Streptomycin
Biolgiai fegyverek bioterrorizmus
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Biolgiai fegyverek bioterrorizmus
Biolgiai fegyverek: Organismusok, Toxinok,Vrusok
Cl: megbetegtse s/vagy elpuszttsaegyneknek, kzssgeknek (populci) gazdasgi krokozs
Biolgiai hadvisels (katonai konfliktus)Bioterrorismus (ideolgiai motivci)
Biolgiai bncselekmny (szemlyes clok,indttatsok)
Biolgiai fegyverek bioterrorizmus
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Kategrik: A, B, Clegveszlyesebb: A
B. anthracis, C. botulinum, F. tularensis, Y. pestis
Egyszertenyszteni
Egyszerterjeszteni: cseppfertzs, lgutakMagas hallozs
Therapia?Hirtelen kezdet (derlt gbl a villmcsaps)Nagy szm ldozat
Biolgiai fegyverek bioterrorizmus
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ZoonosisokLegionellosis
Pseudomonas csoports Acinetobacter
ZoonosisokLegionellosis
Pseudomonas csoports Acinetobacter
Dr.Dr. BerekBerek ZsuzsannaZsuzsanna2008 Okt2008 Oktber 29ber 29
L i ll i
L i ll i
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LegionellosisL eg i o n el l a p n eu m op h i l a
LegionellosisL eg i o n el l a p n eu m op h i l a
Morphologie:Gram negatv plca
Aerob
www.lf3.cuni.cz
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Legionella
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www.waterscan.co.yu
Legionella
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Legionella
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mcb.berkeley.edu
Legionella pneumophila
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Tenyszts:Specilis tptalaj!
BCYE (lesztkivonat, aktv szn)
(pH=9; hmsklet 35C; 3 nap)vresagar
BCYE
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Legionella
tenyszet
www.lf3.cuni.cz
BCYE
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ww
w.contractla
boratory.com
Legionellatenyszet
medecinepharmacie.univ-fcomte.fr
http://medecinepharmacie.univ-fcomte.fr/bacterio_web/exa_microscopiques/examicro_divers.htmhttp://medecinepharmacie.univ-fcomte.fr/bacterio_web/exa_microscopiques/examicro_divers.htm -
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Legionella
Legionella pneumophila
http://medecinepharmacie.univ-fcomte.fr/bacterio_web/exa_microscopiques/examicro_divers.htmhttp://medecinepharmacie.univ-fcomte.fr/bacterio_web/exa_microscopiques/examicro_divers.htm -
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Pathogenesis-1:Fertzs forrsa, elfordulsa:
ubiquiter(klma berendezsek, vzvezetkek,
nedves talaj, biofilm!)
tvitel:aerogen - cseppfertzs!
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www.ratsteachmicro.com
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www.eco-khlamx.com
Legionella pneumophila
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Pathogenesis-2:Fakultatv intracellularis!
Vzben: ProtozoonEmberben:Leukocyta,gyullads,Protease-ok,
Phospholipase-ok
www.lifespan.org
Legionella samoeba
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FIGURE 40-7Electronmicrograph
showingL. pneumophila
serogroup 1 in theprocess of
dividing (arrows)within a vesicle ofan amoeba(Hartmanella
veriformis) cell.
amoeba
Pathogenic cycle of Legionella
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microbewiki.kenyon.edu
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textbookofbacteriology.net/Legionella.jpeg
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Legionella pneumophila
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Krkpek:Legionellosis1) Pneumonia
Lgionrius betegsg
2) Pontiac-lz (non-pneumonis forma)Diagnosis:Krkokoz kimutatsa Biopsia! BAL: direkt IFtenysztsAntigen detektls vizeletblvizeletbl
Antitest kimutats Szerologia; ELISAProphylaxis: Legionella tartalm aerosol kerlse
Therapia:Erythromycin, Tetracyclin, Rifampicin, FQ
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Fig. 2.29 Legionnaires disease. Chest radiograph showing extensive
consolidation affecting parts of all lobes of the lungs.
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Fig. 2.28 Legionella pneumophila. Specimen from bronchial biopsy taken through
fibreoptic bronchoscope in a patient with fulminant Legionnairess disease. The organismcan be isolated on selective culture media or by guinea pig inoculation. By courtesy of Dr.S. Fischer-Hoch
Diagnose
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Fig. 2.30 Legionnaires disease. Autospy specimen showingconsolidation of upper and lower lobes of right lung.
Zoonosis
Zoonosis
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ZoonosisLegionellosis
Pseudomonas csoports Acinetobacter
ZoonosisLegionellosis
Pseudomonas csoports Acinetobacter
Dr.Dr. BerekBerek ZsuzsannaZsuzsanna2008 Okt2008 Oktber 29ber 29
Pseudomonas csoport
Pseudomonas csoport
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Pseudomonas csoportPseudomonas csoport
Pseudomonas P. aeruginosa P
Burkholderia B. malleiP
B. pseudomalleiPB. cepacia
Stenotrophomonas S. maltophilia(Xanthomonas)
P = pathogen
Pseu d om on a s a er u g i n osa
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Morphologia s tenyszts:Gram negativ plca, 1-2 m,ignytelen; Biofilm kpzs!
Pseu d om on a s a er u g i n osa
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Pigmentek:
1. Pyocianin2. Fluorescein
Haemolysis ()
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NAGYON REZISZTENS!
-rezisztenshrefnyre
kiszradsra
ferttlentre
Antibiotikumokra
Pseu d om on a s a er u g i n o sa
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ANTIGENEK S VIRULENCIA FAKTOROK:Adhaesio s colonisatio- "0", "H", Pili/Fimbriae-TOK = Glycocalyx- Alginate slime = mukoid Exopolysaccharid Biofilm kpzsInvasio, Penetratio- Extracellularis Protease-ok, Exoenzymek (sok!)
- Cytotoxin = Leukocidin s Haemolysinek- PigmentekDisseminatio
-Exotoxin AProteinsynthesis gtl (EF2 mint Diphtheria)- Exotoxin/Exoenzym S gsek!; vrbl kimutathat- Endotoxin
LD50
gsi srls esetn 30Normal brfelszn 108
Pili/Fimbriae (megtapads)
Flagellum (Motilits) TOK;
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Pseudomonas aeruginosa Struktura
Extracellularis anyagok
Alginate slime
Medmicro
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No single factor isdecisive for virulence.
Egyik sem kizrlagostnyeza virulenciban!
www.ratsteachmicro.com
Pseudomonas aeruginosaToxin-A hatsmechanizmus
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Inaktiv Molekula
Proteinsynthesis gtlsa
Pseudomonas aeruginosa elmi
Pseu d om on a s a er u g i n o sa
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Pathogenesis, Infectio:
elforduls: mindenhol, ubiquiterfld, vz (uszoda, medence!), szennyvzBlcsatorna emberlgutak: llatok
Fertzs forrsa:betegek, hordozk
Kontaminldott krnyezetoldatok (nedves krnyezet!) manyagok
tvitel: direkt, indirekt Kontaktus
Pseu d om on a s a er u g i n o sa
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Krkpek:Krhzi fertzsek
- Meningitis, Pneumonia (llegeztets!)- Sepsis- gsi srlsek! br, sebek
- hgyuti fertzsek (Katheter),- Blfertzs = hasmens (!), csecsemk- Otitis media, externa- szem + Kontaktlencse
Cystikus Fibrosis /CF/ (mukoid trzsek)
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Fig. 10.2 Pseudomonas folliculitis. Papulopustuler rash over thebuttocks and thights following use of a spa pool.
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Fig. 13-6 Ecthyma gangrenosum. Necrotic round lesion on the buttock of a childwith Pseudomonas septicaemia associated with immunodeficiency.
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Diffuseinfiltrate
Thinned corneal stoma
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Fig. 12.47 Bacterial keratitis, in this case due to P. aeruginosa. Aninfiltrate is seen with corneal thinning. By courtesy of Mr. P.A. Hunter
Edge ofepithelium
Thinned corneal stoma
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Fig. 12.48 Bacterial keratitis. A massive inflammatory response inanterior uveitis leads to precipitation of the cells as pus in the anteriorchamber. This is called hypopyon. By courtesy of Mr. S. Harding
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Fig. 12.49 Bacterial keratitis. P. aeruginosa eye infection showing
corneal ulceration and hypopyon formation in this rapidly progressiveeye infection.
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Pseu d om on a s a er u g i n o sa
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Diagnosis:Krokoz kimutatsa, identifikls, Oxidase +
Therapia s Prophylaxis:Antibiogram!!!Aminoglykosidok, Carbenicillin,antipseudomonas Cephalosporinok, Fluoroquinolonok
Expositios prophylaxis: TISZTASG. Ferttlents.Aktv immunizls cystikus fibrosis
Vakcina
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A conjugate vaccine in the final clinical phase is Aerugen, the first and onlyvaccine for the prophylaxis of fatal Pseudomonas aeruginosa infections incystic fibrosis patients. The polyvalent conjugate vaccine combines 8 prevalentP. aeruginosa serotypes and the bacterial exotoxin A. It is the first conjugatevaccine based on a lipopolysaccharide component.
www.bernabiotech.com
Bu r k h o l d er i a m a l l ei
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Krkp: Malleus (takonykr) l, szamrFoglalkozsi betegsg (magas hallozs)Bioterrorkategoria B!
microbewiki.kenyon.edu/images/3/39/Horse.jpg
A horse withglanders and withpositive mallein test
www.vef.hr/vetarhiv/pap
ers/68-5/alani2
.jpg
Bu r k h o l d er i a p seu d om a l l ei
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Krkp:Melioidosis
Pneumonia,Sepsis
Szubtrpusi,trpusividken
(utazs!)
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B. pseudomallei
www.co.collin.tx.us
www.asm.org
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B. pseudomallei
B. pseudomallei onAshdown's agar afterincubation at 37C in air for 3days
Bu r k h o l d er i a cep a ci a ,
St t h l t h i l i
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St en o t r op h om on a s m a l t op h i l i a
Krhzi fertzsek
Figure 1. Electron micrographs showing expression of flagella by SMDP92.Stenotrophomonas maltophilia strains can have one (A) to several flagella(B,C). The flagella on these bacteria show a polar disposition. Bars, 0.5 m
www.cdc.gov/.../web%20images/01-0535-8t.jpg
Figure 8. Ultrastructuralanalysis ofStenotrophomonas
maltophiliaadhering to
l i (A) S i
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plastic. (A) Scanningelectron micrographsshowing the tight adhesionof SMDP92 to the plasticsurface. (B) Structures
resembling flagella seem tobe protruding andinterconnecting bacteria(arrowheads) or connectingbacteria to the plastic
(arrows). (C) In addition tothe flagellalike filaments(arrowheads), high-powermagnification shows thepresence of thin fibrillar
structures connectingbacteria to the abioticsurface. Bars: A 10 mm, B1 mm, C 2 mm.
www.cdc.gov/.../web%20images/01-0535-8t.jpg
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Stenotrophomonas maltophilia www.uni-ulm.de
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www.oregon.govBurkholderia sp.
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www.uni-ulm.deB. cepacia
Acinetobacter spp.
Acinetobacter spp.
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Morphologia:Gram negatv dimorph
plck, coccobacillusok
www.acinetobacter.org
A ci n et ob a ct er sp p .
T t
www.acinetobacter.org
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Tenyszts:Agar, vresagarfontos: hmrsklet 40-44CNem mozog akinesis
Pathogenesis s Krkpek:mint Pseudomonas aeruginosa
Krhzi fertzsek
Multirezisztens!
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VGEIstanbul, 2006